Monday, March 08, 2010

Throughout the centuries, poets have described a sense of sadness, loss and lethargy which can accompany the shortening days of fall and winter. Many cultures and religions have winter festivals associated with candles or fire. Many of us notice tiredness, a bit of weight gain, difficulty getting out of bed and bouts of "the blues" as fall turns to winter.

However some people experience an exaggerated form of these symptoms. Their depression and lack of energy become debilitating. Work and relationships suffer. This condition, known as Seasonal Affective Disorder (SAD) may affect over 10 million Americans while the milder, "Winter Blues" may affect a larger number of individuals.

The typical symptoms of SAD include depression, lack of energy, increased need for sleep, a craving for sweets and weight gain. Symptoms begin in the fall, peak in the winter and usually resolve in the spring. Some individuals experience great bursts of energy and creativity in the spring or early summer. Susceptible individuals who work in buildings without windows may experience SAD-type symptoms at any time of year. Some people with SAD have mild or occasionally severe periods of mania during the spring or summer. If the symptoms are mild, no treatment may be necessary. If they are problematic, then a mood stabilizer such as Lithium might be considered.[Ed: WTF?!? Hmmm.Sourced!] There is a smaller group of individuals who suffer from summer depression.

SAD is recognized in the DSM-IV (The American Psychiatric Association's diagnostic manual) as a subtype of major depressive episode. The classic major depression involves decreased appetite, decreased sleep, and often, poor appetite and weight loss. It has long been recognized that some depressed individuals had a "atypical depression" with increased sleep and appetite along with decreased energy. Some, but not all of these atypical individuals also had a seasonal pattern. Some people with winter depression also have mild or occasionally severe manic mood swings in the spring and summer. If these episodes are severe, the individual might be diagnosed with Bipolar Disorder. (formerly called manic depressive illness)...

Treatment Options

Outdoor light, even when the sky is overcast, provides as much or more light than a light box[Ed: Not to mention the fact that the only expense associated with gathering outdoor light is your time, whereas a quick Google search for light boxes turns-up a model priced at nearly $500, the Sun Square Plus.] There has been a study showing improvement in SAD symptoms when individuals took a one-hour daily walk outside. Outside light is often brighter than the light boxes. Spending an hour outside each day can often produce beneficial results in some individuals. However, one cannot get early morning outside light in the winter. Not everyone's job will allow for an hour-long outside walk. Only highly motivated people will continue their daily walk when it the rains or snows.

SSRI (Selective Serotonin Reuptake Inhibitors--Paxil, Zoloft etc.) have been shown to be effective in SAD and in some cases of PMS. Some people prefer to take a pill because it is less time consuming than sitting in front of a light box. Some individuals need a combination of light therapy, medication, and psychotherapy. For those with winter depression and spring-summer mania, a mood stabilizer such as Lithium may be useful.

Daily exercise has been shown to be helpful, particularly when done outdoors. For those who tend to crave sweets during the winter, eating a balanced diet may help one's mood. Conversely, as the mood improves, craving for sweets may abate.

Psychotherapy can help the depressed individual look at her depressive assumptions and negative expectations. It can also help one identify relationship difficulties so that interpersonal mistakes might not be repeated. Research has shown that cognitive psychotherapy does help relieve depression faster and more completely than no therapy.

Some individuals continue to have a certain amount of energy fluctuation with the seasons. If one is aware of this, one can plan for it and work the expected fluctuations into one's life plans. [Ed: Or you can simply reject the idea of darkness's ability to kick our butts and format the dual monitors set-up in your spot in the cube farm with a desktop similar to what follows. Sun, Soccer and Señoritas - not so S.A.D. anymore, are you? Enjoy!]

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